Key Indicators of success or survival for clinical performance of fixed partial denture

@#When fixed partial dentures (FPDs) are being suggested to patients, the frequent inquiry by patients is the anticipated longevity and length of service. Previous reports have provided limited information on the accurate measurements of good clinical outcome and the length of good years in service. This confuses the clinicians as well as the patients in determining the treatment of choice. In the present article, the indicator of ‘success’ and ‘survival’ will be discussed in determining the longevity of various FPDs such as conventional, resin bonded and implant retained. After reviewing the articles, it is good if the indicator of ‘success’ can be used as an indicator of longevity and good clinical outcome. Besides that, studies with at least 10 years of observation are probably of higher evidence for longevity of restorations.

All-ceramic premolar guiding plate retains resin-bonded fixed partial dentures / 华西口腔医学杂志

OBJECTIVE@#This study aims to investigate the fracture resistance and short-term restorative effects of resin-bonded fixed partial dentures (RBFPDs) made from heat-pressed lithium-disilicate-based glass-ceramic (IPS e.max press) and zirconia ceramic (WIELAND) and retained by all-ceramic guiding plates when used to restore missing mandibular second premolars.@*METHODS@#A total of 64 human mandibular first premolars and first molars were prepared as abutments, then were randomly divided into 4 groups (n=8): E0, heat-pressed ceramic RBFPDs, no cyclic loading; E1, heat-pressed ceramic RBFPDs exposed to 300 000 cycles of dynamic loading; W0, zirconia ceramic RBFPDs, no cyclic loading; and W1, zirconia ceramic RBFPDs exposed to 300 000 cycles of dynamic loading. Fracture strength was tested in a universal testing machine.@*RESULTS@#The medians of fracture strength were 1 242.85 N±260.11 N (E0), 1 650.85 N±206.77 N (W0), 1 062.60 N±179.98 N (E1), and 1 167.61 N±265.50 N (W1). Statistical analysis showed that all the groups exhibited significantly higher fracture strength compared with the maximum bite force in the premolar region (360 N; P0.05). Significant statistical differences were found between the zirconia ceramic groups (W0 and W1, P0.05) after dynamic loading.@*CONCLUSIONS@#The RBFPDs retained by all-ceramic guiding plates exhibited promising fracture properties and optimal short-term restorative effects when used to restore missing mandibular second premolars.

Flexural strength and hardness of resins for interim fixed partial dentures.

Context: Materials used for the fabrication of interim restorations must satisfy biological, esthetic, and functional needs. Strength and wear resistance are two important physical properties contributing to clinical efficiency. Aim: The objective of this in vitro study was to evaluate and compare the flexural strength and hardness of five resins used for the fabrication of interim fixed partial dentures. Materials and Methods: Five groups containing ten specimens of each material were fabricated in customized brass split molds with dimensions 65×10×2.5 mm. The materials subjected to this study were Revotek LC™ (group RLC), Protemp II™ (group PSC), Acry-lux V™ with regular monomer (group AHC), Acry-lux V™ with self-cure monomer (group ASC), DPI™ self-cure tooth molding powder (group DSC). The specimens were polymerized according to the manufacturers' instructions and were evaluated for flexural strength using a universal testing machine and for hardness using a microhardness tester. Statistical Analysis: The mean of the five groups was compared using one way analysis of variance (ANOVA) and pair-wise comparison was done using Tukeys honesty significance difference (HSD) test. P≤.05 was considered to be statistically significant. Results: Flexural test results showed that group AHC (79.8950 MPa) had the highest flexural strength followed, in descending order, by group PSC (77.9700 MPa), group ASC (63.7150 MPa), group RLC (58.8110 MPa), and group DSC (51.9840 MPa). Statistically, the difference was found to be highly significant among all the groups. The hardness tests showed that group AHC (17.6900 KHN) had the highest hardness value followed, in descending order, by group PSC (15.9400 KHN), group RLC (12.6000 KHN), group ASC (11.2500 KHN), and group DSC (8.7700 KHN). Statistically, the difference was found to be highly significant among all the groups. Conclusion: Group AHC, representing a heat-polymerizing resin, showed the highest flexural strength and hardness values as compared to auto-polymerizing resins and light-polymerizing resin.

Modified resin-bonded fixed partial dentures utilizing tooth undercuts: a clinical case study / 대한치과보철학회지

PURPOSE: The object of this clinical study was to evaluate the short-term outcome of modified resin-bonded fixed partial dentures which utilizes the original tooth undercuts and different path of insertion of components. MATERIALS AND METHODS: 71 units of modified RBFPDs that were used in 21 patients at the Department of Prosthodontics, College of Dentistry, Yonsei University were evaluated. The follow-up period was up to 25 months, the mean being 7 months. Survival rate, mobility, percussion, probing depth, bleeding on probing, plaque index was recorded and radiographs were taken to monitor alveolar bone loss. RESULTS & CONCLUSION: Within the limits of this short term retrospective study, it was concluded that: 1. No mechanical failure such as debonding or fracture of the framework was found during the follow-up period. 2. The periodontal apparatus was stable and no clinical change was observed after prosthetic treatment. 3. No significant marginal bone loss was found in the radiographic evaluation.

Salivary clearance of sugar before and after insertion of fixed partial dentures.

Background: The development of carious lesions is dependent on the presence of acid-producing microflora in the mouth. The activity of these plaque bacteria is dependent on sugar, which diffuses from the saliva following carbohydrate intake. The sugar serves as a substrate for fermentation, producing organic acids that demineralize tooth enamel. Elimination of the sugar from the mouth is accomplished by dilution with newly secreted saliva, a process generally referred to as sugar clearence. Objectives: Determine if fixed partial prosthodontic treatment affects the length of salivary sugar clearance. Materials and methods: Fifteen male subjects age between 21 and 32, and requiring 10 porcelain fixed partial dentures were included in this study. Before receiving their dentures, the subjects, rinsed with a 10% sucrose solution for 30 seconds then gave saliva samples. The prpcedure was repeated one month after the dentures were put in place. The length of sugar clearance was calculated. Results: Salivary sugar was cleared in 14.89±0.89 minutes before the denture application and in 18.86± 0.90 minutes after denture treatment. The initial sucrose concentration was 113.63±1.29 mmol/L before the dentures and 142.99±10.82 mmol/L after the dentures. Conclusion: The use of fixed partial dentures does not affect the time required to clear salivary sugar or the level of the initial sucrose concentration.

Técnica Indirecta Para Reparación De Prótesis Parcial Fija Metal-Porcelana Relato Del Caso

Debido a la excelente estética y biocompatibilidad, las restauraciones con cerámicas son frecuentemente utilizadas en la práctica clínica diaria. A pesar de la evolución de las propiedades mecánicas de las cerámicas, existen casos extensos en que la indicación principal es el uso de coronas metalo-cerâmicas. Frente a la posibilidad de la fractura de esas prótesis, que ocurren del 5 y al 10% en 10 años de uso, existe la opción de reparar dichas prótesis, disminuyendo el costo y el tiempo operacional. Cuando la falla expone la porción metálica de la pieza, se indica una reparación indirecta, que consiste en la confección de una sobre estructura, cementada en la región previamente preparada, a partir de un modelo de trabajo. El objetivo de este trabajo fue demostrar una técnica de reparación indirecta de prótesis parciales fijas utilizando una sobre estructura metalo-cerámica.

Due the excellent esthetic and biocompatibility, metal ceramic restrations are frequently used at clinical daily practice. In sipte of the ceramic mechanical properties evolution, there are extensive cases that the primary indication are metalceramic crowns. Ahead of the possible fractures of these prosthesis, that happen from the 5 to 10% in 10 years of use, there are option to repair it, diminishing cost and chair time. When the failure expose the metal portion it indicates a indirect repair wich consist in manufacturing of a overlay, cemented on region that was previosly prepared, from a work cast. The aim of this study was demonstrate a indirect repair technique of fixed partial dentures using a metalceramic overlay.

A limited and useful approach to determine proximal periodontal health / Un enfoque limitado y útil para determinar la salud proximal periodontal

Previous researchers have shown that there exists an interaction between gingival blood flow and gingival health. The purpose of this study was to compare the papillary blood flow at sites treated by a bridge with the blood flow at untreated sites. Twenty persons with resin-bonded fixed partial dentures were included in the study. The contralateral natural teeth of the site symmetrical to that of the restorations were used as controls. Blood flow was measured from the middle point of the papillae from both test and control sites by Laser Doppler Flowmetry (LDF). The plaque index, papillary bleeding index and probing depth measurements were recorded. There was a statistically significant difference between the test and control sites in papillary blood flow measurements and clinical indices (p < 0.05). Moreover, there was statistical significance between gingival blood flow measurements and papillary bleeding index in the experimental group (p < 0.05). In short, there exists an important relationship between resin-bonded fixed partial dentures and papillary blood flow. Although there were no correlations between LDF values and clinical parameters, it can be emphasized, within the limits of the study, that LDF readings have limited diagnostic value, at least when it comes to clinical performance of fixed prosthesis.

Investigadores anteriores han mostrado que existe una interacción entre el flujo de sangre gingival y la salud gingival. El propósito de este estudio fue comparar el flujo de sangre papilar en los sitios tratado por un puente, con el flujo de la sangre en los sitios no tratados. Veinte personas con prótesis dental parcial fija adherida con resina fueron incluidas en el estudio. Los dientes naturales contralaterales del sitio simétrico al de las restauraciones, se usaron como controles. El flujo de sangre se midió a partir del punto medio de las papilas de los sitios de prueba y de control, usando un medidor de flujo mediante Láser Doppler (LDF). Se registraron el índice de la placa, el índice de sangramiento papilar, y las mediciones para el examen de la profundidad. Hubo una diferencia estadísticamente significativa entre los sitios de la prueba y los de control en las mediciones del flujo de sangre papilar y los índices clínicos (p <0.05). Más aún: hubo una diferencia estadísticamente significativa entre las mediciones del flujo de sangre gingival y el índice de sangramiento papilar en el grupo del experimento (p <0.05). En resumen, existe una relación importante entre la prótesis dental parcial fija adherida con resina y el flujo de sangre papilar. Aunque no había ninguna correlación entre los valores de LDF y los parámetros clínicos, puede subrayarse - dentro de los límites del estudio - que las lecturas de LDF tienen un valor diagnóstico limitado, al menos cuando se trata del funcionamiento clínico de la prótesis fija.

Comparison of stress patterns and displacement in conventional cantilever fixed partial denture with resin bonded cantilever fixed partial denture: A finite element analysis.

Aim: This study aims to analyze the stress patterns and displacement in the cantilever resin bonded fixed partial denture (RBFPD) and compare it with the conventional cantilever fixed partial denture using 3-D finite element analysis. Also, the effect of cement on the displacement and stress patterns in conventional cantilever fixed partial denture was to be analyzed. Materials and Methods: Three-dimensional models were prepared layer wise to depict the conventional cantilever and the cantilever RBFPD. Once the models were made, the material properties were assigned and divided into three groups. (2-conventional cantilever with resin cement, 1- conventional cantilever with GIC cement and 3-resin bonded cantilever with resin cement). Load was applied in vertical as well as lateral directions and the stress patterns along with displacement were analyzed. Results: The results revealed that the von Mises stresses in all the three groups were found to be almost equal under vertical loading. Under lateral loading, the stress was more in cantilever RBFPD. Displacement in all the three axes was significantly less in the cantilever RBFPD. Conclusion: Stress concentration in the lateral direction in cantilever RBFPD was found to be higher than the cantilever conventional group. Displacement in X, Y and Z axes was less in cantilever RBFPD.

Fabrication of fixed partial dentures using functionally generated path technique and double casting.

Harmonious occlusion is a critical requirement for successful oral rehabilitation. Conventional techniques of construction have been unsuccessful in producing a prosthesis that can be inserted without intraoral occlusal adjustment. This article discusses the use of functionally generated path technique with double casting to fabricate fixed partial dentures. The merits of this approach and the technique involved are discussed in detail.

Clinical evaluation of IPS e.max Press all-ceramic crowns and three-unit fixed partial dentures / 中华医学美学美容杂志

Objective To evaluate the clinical performance of IPS e.max Press all-ceramic crowns and three-unit fixed partial dentures(FPDs)and to investigate the periodontal response to the presence of the restorations.Methods According to the inclusion criteria,19 patients with dental defects or singletooth loss were recruited,including 25 crowns and 6 all-ceramic FPDs.The modified United States Public Health Service criteria were used for follow-up evaluation.Plaque index(PI)and sulcus bleeding index (SBI)were recorded for the ceramic restorations and the control teeth.Results No crown and FPD fractures were observed during the evaluation period.There was no statistically significant difference regarding PLI and SBI scores between restorative teeth and the control teeth.And the difference between different recalled times of PLI and SBI of the restorations was no statistically significant.Conclusion IPS e.max Press crowns and three-unit fixed partial dentures exhibit a satisfactory clinical performance.

Dislodgement resistance of modified resin-bonded fixed partial dentures utilizing tooth undercuts: an in vitro study

STATEMENT OF PROBLEM: Over the years, resin-bonded fixed partial dentures (RBFPDs) have gone through substantial development and refinement. Several studies examined the biomechanics of tooth preparation and framework design in relation to the success rate of RBFPDs and considered retention and resistance form essential for increase of clinical retention. However, these criteria required preparations to be more invasive, which violates not only the original intentions of the RBFPD, but may also have an adverse effect on retention due to loss of enamel, an important factor in bonding. PURPOSE: The object of this in vitro study was to compare the dislodgement resistance of the new types of RBFPDs, the conventional three-unit fixed partial denture, and conventional design of RBFPD (Maryland bridge). MATERIAL AND METHODS: Fifty resin mandibular left second premolars and second molars were prepared on dentiforms, according to the RBFPD design. After model fabrication (five group, n = 10), prostheses were fabricated and cemented with zinc phosphate cement. After cementation, the specimens were subjected to tensile loading at a cross head speed of 4 mm/min in a universal testing machine. The separation load was recorded and analyzed statistically using one-way analysis of variance followed by Duncan's multiple range test. RESULTS: Group V, the pin-retained RBFPDs, had the highest mean dislodgement resistance, whereas specimens of group II, the conventional RBFPDs, exhibited a significantly lower mean dislodgement resistance compared to the other 4 groups (P .05). Group V had the highest mean MPa (N/mm2) (P .05). CONCLUSION: Within the limits of the design of this in vitro study, it was concluded that: 1. The modified RBFPDs which utilizes the original tooth undercuts and requires no tooth preparation, compared with the conventional design of RBFPDs, has significantly high dislodgement resistance (P .05). 3. The pin-retained FPDs showed a high dislodgement resistance compared to the conventional three-unit FPDs (P < .05).

All-ceramic and porcelain-fused-to-metal fixed partial dentures: a comparative study by 2D finite element analyses

All-ceramic fixed partial dentures (FPDs) have an esthetic approach for oral rehabilitation. However, metal-ceramic FPDs are best indicated in the posterior area where the follow-up studies found a lower failure rate. This 2D finite element study compared the stress distribution on 3-unit all-ceramic and metal-ceramic FPDs and identified the areas of major risk of failure. Three FPD models were designed: (1) metal-ceramic FPD; (2) All-ceramic FPD with the veneering porcelain on the occlusal and cervical surface of the abutment tooth; (3) All-ceramic FPD with the veneering porcelain only on the occlusal surface. A 100 N load was applied in an area of 0.5 mm² on the working cusps, following these simulations: (1) on the abutment teeth and the pontic; (2) only on the abutment teeth; and (3) only on the pontic. Relative to the maximum stress values found for the physiological load, all-ceramic FPD with only occlusal veneering porcelain produced the lowest stress value (220 MPa), followed by all-ceramic FPD with cervical veneering porcelain (322 MPa) and metal-ceramic FPD (387 MPa). The stress distribution of the load applied on the abutments was significantly better compared to the other two load simulations. The highest principal stress values were low and limited in a small area for the three types of models under this load. When the load was applied on the pontic, the highest stress values appeared on the connector areas between the abutments and pontic. In conclusion, the best stress values and distribution were found for the all-ceramic FPD with the veneering porcelain only on the occlusal surface. However, in under clinical conditions, fatigue conditions and restoration defects must be considered.

Construction of 3-dimensional finite element model of resin-bonded-fixed-partial dentures by dimensional laser scanning and reverse engineering / 实用口腔医学杂志

Objective:To explore a method for setting up three dimensional finite element model of posterior glass fiber reinforced composite resin-bonded-fixed-partial dentures (GFRC-RBFPD) including restoration, periodontal tissue and alveolar bone. Methods:A stone model was fabricated including abutments and pontic of restoration, then it was scanned with laser scanner. Acquired data were integrated in Geomagic 5.0. Basic 3D geometric model was established. Different parts of abutement and prosthesis were designed in I-DEAS 10 NX Series and Geomagic, then periodontal tissue and alveolar bone were set up in Geomagic 5.0. Completed 3D geometric model was input into MSC.Marc Mentat 2003 for mesh generation. Boundary conditions were defined. Model was calculated in Mentat 2003. Results:3D geometric model and finite element model including GFRC-RBFPD, abutments, periodontal membrane and bone (bone lamina dura,cortical bone and cancellous bone) were established.Little contour information was lost, comparability between models was improved.Conclusion:The 3-dimensional laser scanning technique, CAD and mesh generation technique are effective in the establishment of 3-dimensional finite element model of GFRC-RBFPD.